Stroma-normalised vessel density predicts benefit from adjuvant fluorouracil-based chemotherapy in patients with stage II/III colon cancer
Menée auprès d'une cohorte de 312 patients atteints d'un cancer du côlon de stade II/III et validée auprès de 85 patients supplémentaires, cette étude met en évidence une association entre la densité des vaisseaux au niveau du stroma des marges invasives de la tumeur et la survie globale des patients ayant reçu une chimiothérapie adjuvante à base de fluorouracile
Background : Identification of biomarkers associated with benefit of adjuvant chemotherapy in stage II/III colon cancer is an important task.
Methods : Vessel density (VD) and tumour stroma were analysed in a randomised-trial-derived discovery cohort (n = 312) and in a stage II/III group of a population-based validation cohort (n = 85). VD was scored separately in the tumour centre, invasive margin and peritumoral stroma compartments and quantitated as VD/total analysed tissue area or VD/stroma area.
Results : High stroma-normalised VD in the invasive margin was associated with significantly longer time to recurrence and overall survival (OS) (p = 0.002 and p = 0.006, respectively) in adjuvant-treated patients of the discovery cohort, but not in surgery-only patients. Stroma-normalised VD in the invasive margin and treatment effect were significantly associated according to a formal interaction test (p = 0.009). Similarly, in the validation cohort, high stroma-normalised VD was associated with OS in adjuvant-treated patients, although statistical significance was not reached (p = 0.051).
Conclusion : Through the use of novel digitally scored vessel-density-related metrics, this exploratory study identifies stroma-normalised VD in the invasive margin as a candidate marker for benefit of adjuvant 5-FU-based chemotherapy in stage II/III colon cancer. The findings, indicating particular importance of vessels in the invasive margin, also suggest biological mechanisms for further exploration.
British Journal of Cancer , résumé, 2019